Chapter 8

Utilization of Psychosocial Treatments by Patients Diagnosed with Bipolar Disorder and Substance Dependence

Roger D. Weiss, M.D.

Monika E. Kolodziej, Ph.D.

Lisa M. Najavits, Ph.D.

Shelly F. Greenfield, M.D., M.P.H.

Lisa M. Fucito, B.A.

Bipolar and substance use disorders frequently coexist. In a literature review on the subject, Brady and Lydiard 1 estimated that alcohol or drug problems occur in 21% to 58% of patients with bipolar disorder. More recently, Keck and colleagues 2 found that of 106 bipolar patients who were followed for 12 months after hospitalization for either a manic or a mixed-mood episode, 55% met criteria for a substance use disorder. Comorbidity between these two disorders is associated with a worse prognosis than with either diagnosis alone, including slower recovery time 3 and more psychiatric hospitalizations. 4

Despite the high prevalence rate and negative clinical consequences associated with the comorbidity of bipolar and substance use disorders, to our knowledge only one study 5 to date has examined psychosocial interventions among

This study was supported by grants DA09400 (Dr. Weiss), DA00326 (Dr. Weiss), DA00407 (Dr. Greenfield), DA08631 (Dr. Najavits), and DA00400 (Dr. Najavits) from the National Institute on Drug Abuse, Bethesda, MD; grant AA12181 (Dr. Najavits) from the National Institute on Alcoholism and Alcohol Abuse, Bethesda, MD; and a grant from the Dr. Ralph and Marian C. Falk Medical Research Trust, Chicago, IL (Dr. Weiss).

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